Passhonda Williams
Summary
Seasoned Healthcare Customer Service Professional with 6 years of experience in providing exceptional support for Medicare and Medicaid members. Skilled in inbound and outbound call handling, resolving claims, and ensuring HIPAA compliance. Seeking to leverage expertise in patient advocacy and chart retrieval as an Inbound CSR.
Overview
7
7
years of professional experience
Work History
Claims Data Analyst
Centene
09.2024 - Current
- Analyzed claims data to identify trends and discrepancies.
- Reviewed claim submissions for accuracy and compliance with regulations.
- Monitored claim processing systems for efficiency improvements.
- Conducted research on insurance policies to ensure claims were accurate and properly documented.
- Collaborated with internal teams on projects involving updating existing systems or developing new ones.
United Healthcare Advocate/Medicaid/Medicare
TTEC
12.2023 - 09.2024
- Assisted Medicare, Medicaid, and DSNP members with inquiries on plan benefits, claims, and authorizations, achieving first-call resolution.
- Employ deep understanding of healthcare plans to inform and guide members through their coverage options and procedures.
- Resolved member issues and delivered clear, concise information on healthcare services and policies, ensuring high member satisfaction.
Chart Retrieval Specialist
REMX Staffing Agency
03.2023 - 12.2023
- Conducted daily outbound calls to healthcare providers, communicating chart retrieval process and securing submission of required medical charts to support timely patient care.
- Maintained high volume of daily interactions, averaging 35-40 calls to providers, ensuring timely collection of charts for accurate medical recordkeeping.
- Upheld strict confidentiality and compliance with HIPAA regulations, safeguarding patient records during retrieval and transfer processes to protect patient privacy.
Healthcare Customer Service Representative/Sales
Alorica
10.2019 - 03.2023
- Delivered customer support by resolving inquiries about prescriptions, claims, and insurance benefits, achieving accurate and timely outcomes.
- Guided Medicaid and Medicare beneficiaries through enrollment and service navigation, improving their understanding and access to healthcare services.
- Conducted outbound sales calls to promote healthcare products, increasing customer awareness and driving potential revenue growth.
Education
High School Diploma - General Education
Nash Central High School
Rocky Mount, NCSkills
- Customer Service
- Technical Support
- Call center experience
- Complaint handling
- Customer Engagement
- Outbound Calling
- Sales
- Data management
- Data Entry
- Microsoft Office
- Microsoft Excel
- Microsoft Word
- Microsoft Powerpoint
- Microsoft Access
- Live Chat
- Research
- Hipaa
- Organizational Skills
- Effective communication
- Communication Skills
- Active listening
- Empathy
- Relationship building
Timeline
Claims Data Analyst
Centene
09.2024 - Current
United Healthcare Advocate/Medicaid/Medicare
TTEC
12.2023 - 09.2024
Chart Retrieval Specialist
REMX Staffing Agency
03.2023 - 12.2023
Healthcare Customer Service Representative/Sales
Alorica
10.2019 - 03.2023
High School Diploma - General Education
Nash Central High School